Little Richard F, Dunleavy Kieron
1National Cancer Institute, National Institutes of Health, Bethesda, MD.
Hematology Am Soc Hematol Educ Program. 2013;2013:382-8. doi: 10.1182/asheducation-2013.1.382.
HIV is associated with an excess cancer risk, particularly of lymphoid malignancies. Modern therapeutics has changed the landscape of HIV disease and typical opportunistic complications of AIDS are now largely avoided. Although the risk of lymphoma has decreased, it still remains high. Nevertheless, treatment outcomes have improved due both to improvements in HIV medicine and in cancer therapeutics for the common lymphomas occurring in those with HIV infection. Other hematologic malignancies are rarely seen in HIV-infected patients, but the standardized risk ratio for many of these cancers is higher than in the background population. Principles of cancer care and appreciation for HIV infection as a comorbid condition can guide physicians in setting realistic goals and treatment for this patient population. In many cases, expected outcomes are very similar to the HIV-unrelated patients and therapeutic planning should be based on this understanding. Treatment tolerance can be predicted based on the status of the HIV disease and the cancer therapy being administered. For those hematologic cancers in which transplantation is part of standard care, this modality should be considered an option in those with HIV infection.
人类免疫缺陷病毒（HIV）与癌症风险增加相关，尤其是淋巴系统恶性肿瘤。现代治疗方法改变了HIV疾病的格局，艾滋病典型的机会性并发症如今在很大程度上已可避免。虽然淋巴瘤的风险有所降低，但仍然很高。然而，由于HIV治疗药物的改进以及针对HIV感染者常见淋巴瘤的癌症治疗方法的改进，治疗效果已有所改善。其他血液系统恶性肿瘤在HIV感染患者中很少见，但这些癌症中许多的标准化风险比高于一般人群。癌症护理原则以及将HIV感染视为一种合并症的认识，可以指导医生为这一患者群体设定现实的目标并进行治疗。在许多情况下，预期结果与非HIV相关患者非常相似，治疗计划应基于这一认识。可以根据HIV疾病状况和正在进行的癌症治疗来预测治疗耐受性。对于那些将移植作为标准治疗一部分的血液系统癌症，这种治疗方式应被视为HIV感染者的一种选择。
